Bank of Namibia - FinTech Application Form v2

Name of applicant entity:

Country/Countries of incorporation of entity:

Registration number of entity:

If the entity is not registered in Namibia, please specify if the registration is in process or if there is intention to register the entity in Namibia. Please elaborate. :

List all the countries in which the entity has operational activities and specify the nature of its legal presence in each jurisdiction (e.g. locally incorporated entity, subsidiary, branch, or other arrangement):

Ownership and executive management structure of the entity (Full name, nationality, ownership percentage and position of each owner and executive).:

Website of applicant entity:

Physical address of entity:

Email address of entity:

Type of institution:

Name of contact person / representative of entity:

Contact number of representative:

Email address of representative:

Brief description of the entity (including its activities in the field of financial technology and innovation, whether within or outside of Namibia):

If the applying entity or any of its shareholders has been subject to any pending/ongoing or past legal proceedings in the preceding five years, please provide details. (Including attachments):

Upload cover letter setting out the proposed activity and reasons for sandbox application:

Certified copy of commercial registration and articles of association:

Upload certified copy of the identification document and/or passport for shareholders owning (10%) or more of the entity's ownership (excluding for financial institutions already licensed by the regulator), for executive management and for the contact person:

Upload share certificate or any other valid document to verify ownership:

Upload certificate of good standing with the Social Security Commission and the Receiver of Revenue:

Upload License / Authorization from other domestic Authorities (attached proof):

Upload business plan setting out details of the proposed innovation, supported by any relevant local partnership documentation:

Upload CVs and police clearance reports for the executive managers and/or all shareholders owning 10% or more of the entity’s ownership:

Upload documents to verify effective data protection and cybersecurity (if available):

Upload any other supporting documents e.g. business licenses, compliance certificates, and technical blueprints that the applicant may deem relevant:

Provide a brief explanation of your innovative solution. You can additionally attach a demonstration presentation or any material detailing the innovative solution and business mode.:

Can your innovation currently be licensed under existing financial services regulation?:

If the answer is “no” or “uncertain”, please explain why it does not fit existing license categories or product rules, or why there is uncertainty.:

Would sandbox participation help validate the regulatory or operational viability of your innovation?:

If “yes”, please explain how the innovative solution will achieve this.:

What are the reasons for applying to participate under the FinTech Innovation Regulatory Framework? (select all that are applicable):

There is no alternative way to access the regulator
Testing the innovative solution using a real environment to prove the concept/ product
Lack of a legislative framework to regulate the innovative solution
The innovative solution conflicts with applicable legislation
Licensing a company to implement the innovative solution is difficult/very expensive

Has the innovation that forms the basis for your application been examined or is currently under review by any local or external Regulatory authority?:

If the answer is “yes”, please provide us with the name of the Regulatory authority and the results of the examination process that was carried out, if it has completed an assessment of your solution.:

Please explain how your business model interacts with any applicable existing regulations.:

Please explain how your innovative solution falls under the regulator’s remit.:

Does your innovative solution require formal approval from the Bank before it can be launched in Namibia?:

Does your innovative solution involve any of the following (select all that apply):

Banking Services
Exchange Control Services
Payment Services
Virtual Assets
N/A
I do not know

Provide details on how your innovation interacts with any financial services regulated entities (if applicable):

Please select your current stage of development (select one):

Concept only
Prototype (non-functional demo)
Functional minimal viable product (MVP)
Fully functional product, not yet launched
Already operating informally

Does your innovation require cooperation with third parties?:

If the answer is “yes”, please specify these entities/ third parties, and the nature of the relationship. Note whether they are regulated by any financial regulatory authorities and, if so, by whom.:

What technology is used in the innovative solution?:

Describe your operational readiness (team capability, capital, systems) to commence testing.:

Please indicate how long you anticipate it would take before you are ready to start testing your innovation with real users, should your application be successful.:

< 3 months
3 months
3 – 6 months
6 – 12 months
> 12 months

What are the expected benefits of the innovative solution for the Namibian economy? (select all that apply):

Enhance access to financial services, including underserved groups
Enhance competitiveness
Improve the level of efficiency of financial services
Provide job creation
Provide market expansion
Improve digitalisation
Improve customer experience
Improve affordability
Improve distribution channels for difficult-to-reach markets

Please explain how your innovative solution will result in these benefits (selected above), whether directly or indirectly?:

What direct benefits will customers experience from your solution?:

What are the targeted customer categories for the innovative solution?:

What existing challenges and obstacles does your application solve?:

What added value will your innovative solution provide to Namibian consumers that is not already available within the market?:

How many customers do you estimate will benefit from this solution, both within the sandbox pilot and in the years thereafter? Please explain how you estimated this, and your assumptions used.:

What strategies do you have in place to scale your solution?:

Describe the potential risks to your customers (both retail and businesses) that may arise from testing your product/service and the measures you will institute to safeguard your customers.:

How do you plan to ensure that the terms and conditions, pricing/cost, benefits and processes are clearly communicated to your target customers?:

What measures will you put in place to protect the confidentiality and integrity of customer data? [including attachment outlining the measures]:

What procedures and mechanisms will you put in place to handle customer complaints?:

What procedures will you put in place to identify customers and conduct due diligence as per the KYC requirements of Namibia’s Financial Intelligence Act (FIA). [including attachment outlining the measures]:

From the list of risks, please describe the extent/significance of each risk to your innovation and how you plan to mitigate their severity: 1. Operational risks, 2.AML/CFT Risks, 3.Compliance risk, 4.Reputation risk, 5. Data protection risk, 6. Cybersecurity risks, 7. Legal risk :

Describe the key objectives and measurable outcomes of the live test of your innovative solution under the sandbox or allow-and-see programmes.:

Describe how you propose to conduct the testing: o The start and end date of the testing o Your target customers (client type) for the testing, how they will be selected and your customer acquisition strategy o The maximum number of test customers you wish to involve o Transaction thresholds (if applicable) o Other quantifiable limits:

Describe your communication plan to inform customers of the following: o Disclosure that the product is operating within the Sandbox or on an Allow-and-See basis o The duration, boundary conditions and the associated risk for participating in a programme; and o Advance notification of termination or extension of the programme or when the solution is to be deployed at a broader scale.:

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FinTech Application Form v2

Summary

FinTech Application Form (Testing)

FinTech Application Form v2

Summary

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FinTech Application Form (Testing)